title: [Conversion from +Sandimmune to Neoral in kidney transplant recipients treated with cyclosporine and ketoconazole].
abstract: BACKGROUND
  Microemulsion cyclosporine is a new pharmaceutical form whose intestinal absorption is more constant, resulting in a better bioavailability.
  
  
  OBJECTIVE
  To assess dose adjustments and variability of blood levels after the conversion of cyclosporine to microemulsion cyclosporine in renal transplant recipients function receiving cyclosporine-ketoconazole.
  
  
  METHODS
  Thirty four patients with more than one year after the transplantation, with stable renal function and receiving triple immunosuppression were studied. Conventional cyclosporine was changed to the microemulsion form maintaining the same daily dose. Drug serum levels, serum creatinine and blood pressure were measured within two to eight months after the conversion. Doses of microemulsion cyclosporine were adjusted to achieve serum levels of 150 +/- 40 ng/ml.
  
  
  RESULTS
  Microemulsion cyclosporine induced a slight initial increase in blood cyclosporine levels. Afterwards, levels were more stable than with conventional cyclosporine (165-185 and 145-210 ng/ml respectively) and the dispersion of values were lower (standard deviations of 70 and 100 ng/ml respectively). Twenty three patients did not require dose adjustments, in four it was reduced and in five it was increased. There were no changes in serum creatinine or blood pressure after the conversion.
  
  
  CONCLUSIONS
  More stable serum levels without adverse reactions were obtained with microemulsion cyclosporine. Doses of cyclosporine need not to be changed during the conversion.
authors.affiliation: Unidad de Nefrologíia, Servicio de Medicina Hospital Gustavo Fricke de Viña del Mar, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Videla
authors.forename: J
authors.initials: J
authors.lastname: Vega
authors.forename: H
authors.initials: H
authors.lastname: Borja
authors.forename: A
authors.initials: A
authors.lastname: Gatica
authors.forename: R
authors.initials: R
authors.lastname: Clavero
authors.forename: T
authors.initials: T
authors.lastname: Aldunate
mesh_terms: D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology; D004655:Emulsions; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology; D007654:Ketoconazole / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged
chemical_list: D000935:Antifungal Agents; D004655:Emulsions; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D007654:Ketoconazole
vernacular_title: Conversión de Sandimmune a Neoral en pacientes trasplantados renales que reciben ciclosporina-ketoconazol.